July 16, 2009

I’ve been using Facebook for all my blogging needs lately, including all the details of my upcoming cancer surgery. I’ve tried to set my profile to be world readable so you should be able to see all the posts as long as you’re logged into Facebook even if you’re not on my friends list. Kindly let me know if you find this is not the case.

August 6, 2004

Today my beloved dog Roger underwent major knee surgery to correct a torn cruciate ligament that was making his knee unstable and painful.

There are two ways to fix a cruciate ligament. One is to replace it with an artificial ligament fashioned out of sutures which takes over the job of bearing the stress and holding the joint together. This works best in smaller, less active dogs.

For bigger, stronger, more athletic dogs like Roger, it’s better to use a procedure called TPLO (Tibial Plateau Leveling Osteotomy) in which the top of the tibia is cut, rotated, and bolted into a flatter position. By changing the angle at which the femur meets the tibia, this operation eliminates the need for a cruciate ligament altogether because there’s no longer an angled surface to slip on. It’s a better design than nature’s original.

The boy comes home tomorrow and begins a month of very restricted activity. He’ll spend most of his time in a small room or a crate until his bone heals. Then we’ll gradually increase his activity. Within three months, he should regain his full former level of athletic ability and be able to run hard with the other dogs at the park again.

Filed by heydan at 12:13 am under UncategorizedComments Off on Dog Surgery

January 13, 2004

Yesterday I spent four hours on the operating table with my throat cut wide open and today I’m already back home. It was almost drive through surgery! [Note: I added the above photo more than a week after surgery. It doesn’t heal *that* fast.]

The surgeon said it was a difficult operation, but his hard work translated into an easy time for me. I slept through the whole thing and recovered quickly afterwards.

He found and removed two tumors (one thyroid and one parathyroid) and both appeared to be benign (to be confirmed by further lab tests). My lymph nodes, which appeared enlarged on ultrasound, turned out to be normal. One of my remaining parathyroid glands, which also appeared enlarged on ultrasound, also turned out to be normal. My blood calcium level is now normal, which was the symptom which started this whole thing.

So it appears everything went perfectly and I’m probably completely cured now. It’s the best possible result I could have hoped for.

I’m immensely impressed by the skill and dedication of the doctors who took care of me. Both my internist and my surgeon are brilliant, hard working, super nice guys. I think they’re the best in the world at what they do. And yet, as good as they are, they know medicine is not an exact science. They struggle hard to make the right decisions and sweat over it until the outcome is known. So I would also add “courageous” to my list of praise for them. They dearly want everything to turn out well but the task they do is sometimes so difficult that they know they can’t always prevail.

In my case, there were two additional parathyroid glands which couldn’t be seen on ultrasound and which couldn’t be found during surgery either. The surgeon spent a lot of time looking for them but finally had to give up. I think by the time he abandoned the search he was becoming concerned about the risk of doing me harm by poking around so much and for so long. He looked relieved when he visited me after surgery and saw me being bright and happy. He told me he’d sleep better that night because he didn’t have to worry about me.

I think that must be a hard part of his job, the concern that despite all his skill and best efforts he won’t always be able to get the results he wants. Some days he’ll have to go home knowing he either didn’t manage to cure someone or possibly even made them worse by trying. But not today. Today I am another one of his many success stories.

[Update: The final pathology report came back and confirmed both tumors were benign. I’m cured!]

December 19, 2003

When my doctor told me a routine blood test had showed excess calcium in my blood, I thought it was a minor problem, the kind of thing you might have to take vitamins for. But it turned out to be the first sign of something more complicated.

Calcium levels are controlled by your parathyroid glands, of which you have four, embedded into the back of your thyroid gland. When you have too much calcium in your blood, it can indicate a parathyroid tumor, a group of cells growing out of control and doing their job overtime without listening to the body’s normal feedback mechanisms. This depletes your bones of calcium, which causes osteoporosis, and sends it out through your urine, which causes kidney stones. Fatigue and excessive thirst are other symptoms, which I’ve had for some time now.

After the blood test I was sent for an ultrasound scan of my throat and that’s when I started getting some surprises. Of the four parathyroid glands, only two of them were visible on ultrasound because the other two were located behind the collar bone, but BOTH of the visible ones were greatly enlarged, indicating tumors. I was surprised there was more than one tumor and, since there are two more parathyroid glands we couldn’t see, maybe more than two tumors.

The next surprise was that there were also two tumors visible on the thyroid gland, one too small to worry about but one large enough that you can actually feel it through the skin if you know what you’re looking for. And there were also two enlarged lymph nodes, which could indicate that cancer from the thyroid has spread to the lymph nodes. Or maybe not. We won’t know until surgery.

This is going to be an operation where they have to make up a few things as they go along. We know the two enlarged parathyroid glands we can see have to be removed but the other two are a mystery right now. They’ll require exploratory surgery to see if anything’s wrong with them. If so, the surgeons will remove the worse one and leave all or part of the better one.

The thyroid tumor will also require some quick decisions during surgery. They’ll remove it, freeze it, and take a section of it to inspect while I’m still on the table. If it looks cancerous, the rest of the thyroid gland has to be removed and I’ll have to take synthetic thyroid pills every day for the rest of my life. I’ll also get treated wtih radioactive idione to kill off any cancerous cells which may have spread through my body. The good thing about thyroid cells is that they are the only tissue which absorbs iodine, so you can use radioactive iodine to track them down and kill them wherever they are.

I have the best surgeon in the world for this, I think, but the first opening in his schedule was a month away so I’m counting the days until then. Usually I like to prepare for the worst case so I can be pleasantly surprised, but in this situation the worst case is pretty bad and not very likely, so I’m trying to stick to a zen-like state of just not knowing for now.

March 28, 2003

“No one will ever love you as much as your dog does. He will follow you devotedly. He will accept your scoldings and still think you’re wonderful. He will do your every bidding. He will sit, heel, stay, and come when you call. He will sleep by your bed, defend you from enemies, and be your friend until he dies.” — Jean Craighead George

“We are alone, absolutely alone on this chance planet; and amid all the forms of life that surround us, not one, excepting the dog, has made an alliance with us.” — Maurice Maeterlinck

“He showed us then in full perfection what was afterwards to be an inconvenient — if endearing — characteristic: At any call or whistle he would look in precisely the opposite direction. How many times all through his life have I not seen him, at my whistle, start violently and turn his tail to me, then, with nose thrown searchingly from side to side, begin to canter toward the horizon!” — John Galsworthy

“What’s important to them [dogs] is that there is fun happening, and that they are having as much fun as we are. They are happy to sacrifice their dignity so that everyone can have a good time. If dogs were comedians, then taking a pie in the face would be their best routine. ‘Anything for fun’ is their motto.” — Matt Weinstein and Luke Barber

“Dogs don’t make a distinction between work and play. Everything is fun to them, and every situation is a new one, full of infinite possibilities for joy and connection. We humans surely would be more successful in our jobs if we approached our work with the enthusiasm, dedication, sensitivity, and the wonderful attitude towards life in general of a good working dog.” — Matt Weinstein and Luke Barber

“If there are no dogs in Heaven, then when I die I want to go where they went.” — Will Rogers